Healthcare’s Dual Demands Fiscal Responsibility and Quality Care

The US healthcare system consumes approximately 32 billion gallons of water and $6.5 billion in energy per year while producing 2 million tons of waste. Every day that a healthcare provider burns more energy, uses more water and creates more waste than it requires is another day of pouring both money and resources down the drain. Every unit of energy, water, and waste processing is purchased at the expense of an investment directly enhancing the quality of patient care.

For healthcare managers striving to balance the competing demands of fiscal responsibility and quality care, the elimination of unnecessary operating expenses and the increased allocation of resources into patient care is a demonstration of good management. However, decisions relative to energy and water are mission critical for a hospital. Because it requires the highest level of expertise in many different areas of inquiry, the challenge is daunting.

Successful development of an Environmental Action Plan requires a team equipped to draw upon state-of-the-art technology and design concepts and an ever-expanding knowledge base followed by financial analysis, project management, stakeholder engagement, metrics and data management and communication skills focused on implementing the plan.

We approach the task in a continuous improvement context that utilizes a team of global specialists. We bring the best talent to the table only as and when needed for the specific task at hand.

Energy/Water Resource Management

We assess existing energy and water utility consumption and costs by setting a baseline to be measured against and then identify alternative energy and water efficiency measures with a focus on decision quality. A technology assessment would determine whether existing systems can accept and manage the data necessary to measure and report performance, then a team will implement actions necessary to support the plan’s success. We maintain decision quality by properly framing the problem, establishing clear decision criteria and well-articulated institutional values. We focus on achievable options and clean tradeoffs, utilizing meaningful information and logical reasoning based upon the data at hand and improvement targets selected. We strive to ensure that the process is transparent to stakeholders and we seek a commitment to action. One way this is accomplished is by making the information and data analysis available to stakeholders at appropriate levels.

Carbon Emissions Planning

Carbon emissions planning benefits progressive institutions that (1) recognize the significant cost exposure associated with a future price on carbon, and/or (2) want to brand themselves as leaders and innovators. For institutions desiring to brand themselves as leaders and healthcare’s dual demands fiscal responsibility and quality care healthcare’s dual demands fiscal responsibility and quality care innovators, we will augment the Environmental Action Plan analysis with the potential risk of financial exposure due to carbon emissions. We will develop a comprehensive strategy that addresses the implications of alternative carbon metrics (carbon- or energy-intensity per patient or per bed, rather than the per-square-foot metric used by the building industry). This approach would shift the focus from the building to the patient, expanding the audience from facilities to operations. And likely drive very different solutions.

Waste Stream Management

Approximately 23% of hospital waste streams consist of medical and hazardous waste with the remaining waste classified as trash or recyclable. Any waste streams that are not separated can be 100% medical. We assess the current waste stream and benchmark that against peer organizations as part of a preliminary assessment. Next, internal waste control processes are assessed along with procurement policies, regional pricing and regional regulatory requirements. Next, utility allowances, hospital waste infrastructure, recycling and repurposing opportunities are further explored to increase efficiency and lower costs. We then identify alternative options using the decision quality process described above. Results include a reduction in waste separation errors through mechanization of the waste stream, lower storage and cartage costs and lower FTE costs related to waste stream management.

Metrics and Information Management

Following the assessment of energy, water and waste protocols and data management, we recommend alternative solutions and, working with the procurement organization, assist in selection, procurement and implementation of technology solutions. A typical solution would interface with an existing Integrated Workplace Management System (IWMS) or Computer Aided Facility Management (CAFM ) system to manage data for reporting at facility management, operations and executive dashboard levels in the organization. We identify current inputs and outputs of energy, carbon, water and waste and assign costs per unit, using industry-specific metrics. This forms the benchmark against which we will measure savings and efficiency.

Employee Engagement Program

To ensure the successful implementation of new operating protocols, we develop an employee engagement program that enlists and encourages employees to engage in new behaviors supportive of the organizational goals. Employees are asked to share their innovative idea to reduce operating costs. Utilizing the technology applications implemented at the outset of the engagement, cost savings affected through the implementation of employee innovations are measured, reported and recognized, building support and enthusiasm among the employee population.

Cagri Kanver - MBA, MS Space Management. Senior Associate, HOK Advance Strategies. Cagri Kanver has eight years of progressive experience in the field of global real estate development as a senior consultant. He advised global corporate clients in multiple areas of strategy and operations improvement initiatives and corporate sustainability strategies in the real estate. He led number of engagements in the areas of strategic business planning & programming, market research & analysis for global site selection and development.Cagri performed professional projects in four different continents; especially specializing in the Middle East and Asian markets for large mixed use developments. He developed key global client relationships in academic, corporate, government, healthcare, hospitality & leisure markets. Prior to joining HOK, Cagri worked for Deloitte Consulting as a senior consultant. Cagri speaks English, German, and Turkish.